Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.12I hereby apply for REALTOR Membership to (Realtor® or Secondary Realtor®)*The Kershaw County Board of Realtors, the South Carolina Association of Realtors®, and the National Association of Realtors. I am enclosing my check for fees in the amount of $ which is to be returned to me in the event of non-election. In the event of my election, I agree to arbitrate all contractual disputes with fellow REALTORS® and to abide by the Code of Ethics of the National Association of Realtors®, and the Constitution, By-Laws, and Rules and Regulations of the above named Board/Association, the State Association and the National Association. I consent that the Board/Association, through its Membership Committee or otherwise, may invite and receive information and comment about me from any Member or other person, and I further agree that any information and comment furnished to the Board/Association by any person in response to the invitation shall be conclusively deemed to be privileged and not from the basis of any action by me for slander, libel, or defamation of character. I hereby submit the following information for your consideration: Name as shown on Real Estate LicenseLicense No. SelectBrokerSalesmanHome Phone Email Address(Enter in database)YesNoCell PhoneOffice Address Office Address CityStateZipMailing Address (If different) Mailing AddressCityStateZipHome Street Address Home Street AddressCityStateZip(State Association files will be setup with all addresses. Immediately notify your Local Board/Association of any changes.) Name of FirmOffice Phone # Office Fax #Office Email Address:My title or position with the firm Partners or Office (if a corporation)Are you actively engaged in the real estate business? YesNoDo you hold yourself out to the general public as being actively engaged in the real estate business? *YesNoYou are authorized to contact the following references: NameNameAddressAddressPhonePhoneNextPERSONAL DATA Applicant: Date of Birth (Nickname) *First entered the real estate business 20 atHave you been engaged continuously in the business since then? *YesNoIf not, during what years were you in the business? *How many years have you been active as a: Salesman BrokerList membership in professional societies, fraternal orders, service organizations, Boards/Association of Realtors®, political office, etc. *First licensed in SC 20and continuously licensed since Established in present location: 20Last previous location Resident here since 20Previous residence Are you, or have you been a Member of any Local Board/Association?YesNoIf yes, which one(s) Have you participated in a Multiple Listing Service?YesNoIf yes, where?What amount of your business time do you devote to real estate? Which branches of real estate do you specialize in? (check all that apply) Single-family Homes SalesNew Home SalesCommercial AppraisingProperty Management OtherAre you now employed in any other business or profession? *YesNoPositionLocationDateWill you serve on a State or Local committees (if appointed)?YesNoCommittee preference Have you or your firm ever been disciplined by a Local Board/AssociationYesNoBy a licensing agency?YesNoIs so, give details*attach separate sheet(s) as needed. Click or drag a file to this area to upload. Membership Application Fee *Local: Application fee: $30.00 and Local dues: $180.00State: State Dues: $130.00; State Legal Assessment fee: $25.00(New Members Only) and Issues Mobilization Assessment: $10.00National: National Dues: $120.00 and National Campaign Advertising Fund $35.00Checkbox ItemsFirst ItemSecond ItemThird ItemSubmit
